Mass spectrometric immunoassay

ABSTRACT

Rapid mass spectrometric immunoassay methods for detecting and/or quantifying antibody and antigen analytes utilizing affinity capture to isolate the analytes and internal reference species (for quantification) followed by mass spectrometric analysis of the isolated analyte/internal reference species. Quantification is obtained by normalizing and calibrating obtained mass spectrum against the mass spectrum obtained for an antibody/antigen of known concentration.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation application of pending applicationSer. No. 11/462,504 filed on Aug. 4, 2006 which is a continuation ofapplication Ser. No. 09/808,314 filed on Mar. 14, 2001, now abandoned,which is a continuation application of pending application Ser. No.09/024,988 filed on Feb. 17, 1998, now abandoned, which was acontinuation of original application Ser. No. 08/449,903, which wasfiled on May 23, 1995, now abandoned.

Financial Assistance for some of the work reported herein was providedby the United States Department of Energy under Grant numberDEFG02-91ER61127. The United States government may have certain rightsto this invention.

INTRODUCTION

The present invention relates to a new and useful immunoassay and morespecifically to new and improved mass spectrometric immunoassayprocesses for the detection and/or quantification of one or moreantigens or antibodies in a single determining immunoassay. Hereinafter,singular terms are intended to include plural.

BACKGROUND OF THE INVENTION

Immunoassay techniques first came into wide usage with the developmentof radioimmunoassay (RIA) in which the specificity of antigen-antibodybinding was coupled with the high sensitivity of nuclear particledetection to detect and quantify antibody-antigen binding in thepresence of a large background of non-specific material. Later, enzymeimmunoassay (EIA) and enzyme-linked immunosorbent assay (ELISA)immunoassays coupled the specificity of antigen-antibody binding withthe sensitivity of enzyme chemical reactions to detect and quantify anantigen-antibody binding by producing colored, fluorescent, bio- orchemiluminescent chromophore. EIA and ELISA exhibited an amplificationfactor as high as 10⁸, allowing sensitivities competitive with RIAwithout the disadvantages of radioactivity.

Typical ELISA diagnostics relied on an antigen having at least oneepitope to which an enzyme-linked antibody could bind with a highaffinity. An antigen was affinity-isolated from its biological systemand allowed to interact with the enzyme-linked antibody. The enzyme ofchoice was generally alkaline phosphatase or horseradish peroxidase,both of which generated a colored product upon digestion of appropriatesubstrates. Although detection of attomole levels of an enzyme has beendemonstrated, so that it was, in principle, possible to detect attomolelevels of an antigen, traditional immunoassays did not operate at thatlevel of detection because all were limited by non-specific binding ofthe enzyme-linked antibody to surfaces in the reaction well or vial.This produced a background response which restricted the detection limitof the technique which could not be discriminated against becausedetection was indirect.

A further limitation of the traditional immunoassays employing opticaldetection was caused by the limited number of clearly resolvable coloredenzyme products, at most two or three, which limited the possibility foran immunoassay to screen for multiple antigens in a single sample.Multiple antigen immunoassays usually focused on a number of separateimmunoassays in an array of well plates each requiring its own samplewhich clearly reduced the utility of this approach. The idealmulti-antigen immunoassay would detect a large number of discreteantigens with high specificity in a single specimen, would cover a largedynamic range, be quantifiable over that range, and could be performedrapidly, that is, in minutes rather than hours, for critical clinicalsituations and high general throughput.

The sensitivity of EIA and ELISA relied on the specificity of theaffinants used to bind with the antigen or antibody being detected.Expensive and hard to produce monoclonal antibodies were usually thereagent of choice because the specificity of monoclonal antibodies isvery high. Polyclonal antibodies whose specificity is low could be usedin theory but were not a practical choice for a reagent becausepolyclonal antibodies bind with several species of antigens making thedetection of the resulting antibody-antigen complex less specific for asingle given antigen species.

Yet another restriction to EIA and ELISA is that they required theantigen-antibody binding to reach an equilibrium for quantification,making the immunoassay take several hours to perform.

Until about 1988, mass spectrometry of proteins and peptides was thoughtdifficult or impossible. At that time Karas and Hillenkamp (AnalyticalChemistry, vol. 60, pp. 2299-2301, 1988) demonstrated that proteinscould be ejected into the gas phase by embedding them into an organicmatrix which was then literally exploded using a pulsed laser beam. Thistechnique is commonly referred to as matrix-assisted laserdesorption/ionization (MALDI). When MALDI was coupled to atime-of-flight (TOF) mass spectrometer, a new field of biological massspectrometry was opened.

While the new MALDI techniques opened the field of biomolecular massspectrometry, the mass spectrometric analysis of complex biologicalmaterials was not possible because of matrix overloading. Recently,Hutchens et al. (Hutchens, T. W. and Yip, T., Rapid Communications inMass Spectrometry, vol 7, 1993, pp. 576-580.) demonstrated theutilization of affinity capture methods to quasi-purify proteins in aspecimen prior to MALDI mass spectrometry. By quasi-purifying thespecimen being assayed Hutchens et al. effectively overcame the primarylimitation of MALDI mass spectrometry, namely, the suppression of ionsignal due to overloading of the matrix. They named their technique“surface-enhanced affinity capture mass spectrometry (SEAC)”. Theyfurther demonstrated their technique by using single stranded DNA whichthey immobilized on the mass spectrometer probe tip to quasi-isolate theprotein lactoferrin from preterm infant urine.

More recently Hutchens, T. W. and Yip, T., in an international patentapplication which was published 8 Dec. 1994 (WO 94/28418), described amethod and apparatus for using affinity capture to improve massspectrometric characterization of biomolecules.

Presently, there is no mass spectrometric immunoassay which is capableof qualitatively and quantitatively determining the presence of singleor multiple antigen or antibody species in a specimen. It is toward thefulfillment of that need that the present invention is directed.

BRIEF SUMMARY OF THE INVENTION

The present invention relates generally to the fields of immunoassay andmass spectrometry and more particularly to a new and useful massspectrometric immunoassay methodology for unequivocally detecting and/orquantifying one or more antigens or antibodies from a specimen withinthe limits of detection.

The present invention combines and exploits the specificity ofantibody-antigen binding and the ability of the mass spectrometer tounequivocally identify molecules in various qualitative and quantitativestrategies to analyze one or more antigens or antibodies in a specimenwithin the limit of detection. Both qualitative and quantitativestrategies utilize an antibody or antigen to capture and isolate anotherantigen or antibody, respectively, from its surroundings, and thereaftermass spectrometrically analyze the isolated antibody or antigen afterrelease from the capturing agent. This specificity of theantibody-antigen reaction coupled with the ability of the massspectrometer to separate and unequivocally identify the captured andisolated antibody or antigen by its mass-to-charge ratio from othermolecules that may accompany it lends two dimensions of specificity tothe present invention.

Because detection using mass spectrometry lends an added dimension ofunequivocal specificity, the mass spectrometric immunoassay under thepresent invention is an improvement over existing immunoassays inseveral ways. First, the present invention does not require monoclonalantibodies as a reagent, polyclonal antibodies produce equally reliableresults. Second, radioactive materials are not required at all. Third,the presence of other substances not the subject of the immunoassay donot interfere with either detecting or quantifying the targeted antigenor antibody. Fourth, an accurate multiplex immunoassay clearly detectingand/or quantifying virtually any combination of different antigens orantibodies is possible.

In addition, the rapid ease by which the mass spectrometer can detect anantigen or antibody regardless of whether the antigen-antibody bindinghas reached equilibrium grants to the present invention an immunoassaythat produces results in a short period of time, minutes rather thanhours.

An article by Nelson, R., et al., published in Analytical Chemistry,vol. 67, pp 1153-1158, on or about Mar. 31, 1995, describes certainportions of the present invention in detail.

Accordingly it is a prime object of the present invention to provide anew and improved mass spectrometric immunoassay for determining whetherone or more designated antigens and/or antibodies are present in aspecimen.

A further object of the present invention is to provide a novel andunique immunoassay for determining what specific antigens and/orantibodies are present in a given specimen.

Another object of the present invention is to provide a new and improvedimmunoassay for determining how much detected antigen or antibody ispresent in a specimen.

These and still further objects as shall hereinafter appear are readilyfulfilled by the present invention in a remarkably unexpected manner aswill be readily discerned from the following detailed description of anexemplary embodiment thereof especially when read in conjunction withthe accompanying drawing in which like parts bear like numeralsthroughout the several views.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a depiction of the general scheme of a multiplex massspectrometric immunoassay under the present invention showing affinitycapture and isolation of two antigen analytes and a modified variant ofone of the antigen analytes, denoted with a star, and showing theresulting mass spectrum which distinctly resolves each antigen analyteand modified variant;

FIG. 2 is a mass spectrum resulting from the mass spectrometricimmunoassay of the present invention of a venom-laced human blood samplefor the antigen, myotoxin a, showing a distinct mass spectrometricresponse for singly charged myotoxin a at the mass/charge (m/z) ratiocorresponding to the molecular weight of myotoxin a at 4,822 Da, and asecond distinct response at the m/z ratio corresponding to 5,242 Da,which is the molecular weight of the modified variant H-myotoxin a, usedas an internal reference species;

FIG. 3 is a mass spectrum resulting from mass spectrometric analysis,without affinity capture and isolation, of a venom laced human bloodsample for the antigen, myotoxin a, showing no distinct massspectrometric response at the molecular weight of myotoxin a, but rathershowing a mass spectrometric response for singly charged hemoglobin Aand B at the mass/charge (m/z) ratios corresponding to their respectivemolecular weights of about 16,000 Da;

FIG. 4 is a working curve relationship between the concentration ofmyotoxin a in venom laced human blood samples and the magnitude of massspectrometric immunoassay responses for myotoxin a, normalized with themodified variant, H-myotoxin a, and demonstrating the working curvequantification strategy for quantifying myotoxin a;

FIG. 5 is a mass spectrum resulting from the mass spectrometricimmunoassay of the present invention of a venom laced human blood samplecontaining four modified variants of myotoxin a, demonstrating thebargraph quantitative strategy for quantifying the antigen, myotoxin a;

FIG. 6 is a mass spectrum resulting from the mass spectrometricimmunoassay of the present invention of a venom laced human blood samplecontaining the modified variant, H-myotoxin a, demonstrating therelative limit signal quantitative strategy for quantifying myotoxin a;

FIG. 7 is a mass spectrum resulting from the multiplex massspectrometric immunoassay of the present invention of a venom lacedhuman blood sample for myotoxin a and Mojave toxin showing distinct massspectral signals for myotoxin a and Mojave toxin located at theirrespective molecular weights;

FIG. 8 results from the mass spectrometric immunoassay of the presentinvention of six preparation samples containing various concentrationsof the antigen, α-1-acid glycoprotein (A1AG), and a constantconcentration of the internal reference species, human serum albumin(HSA) and is a mass spectrum of one of these preparation samples,showing distinct signals for A1AG at m/z˜37,000 and for HSA atm/z˜67,000;

FIG. 9 is a working curve relationship between the concentration ofα-1-acid glycoprotein (A1AG) in a specimen and the magnitude of the massspectrometric response for α-1-acid glycoprotein, normalized with theinternal reference species, human serum albumin;

FIG. 10 results from the mass spectrometric immunoassay of the presentinvention of the rattlesnake toxin, myotoxin a, in human bloodcontaining the venom of the Mojave rattlesnake, and to which variousaliquots of purified myotoxin a have been added to allow quantificationby the standard addition strategy, and shows a mass spectrum of a samplein which the concentration of myotoxin a was increased by 1250 nM overthe intrinsic level;

FIG. 11 is the standard addition line defining the relationship betweenadded myotoxin a and the mass spectral responses for myotoxin a,normalized to the mass spectral response for another venom component,Mojave toxin, which is present in the blood sample at a constantconcentration and consequently may be used as an internal referencespecies;

FIG. 12 is a mass spectrum of a venom laced blood sample containing fivemodified variants of myotoxin a resulting from the mass spectrometricimmunoassay of the present invention in Example 7, demonstrating abargraph quantification strategy;

FIG. 13 is a mass spectrum resulting from mass spectrometric analysis ofthe preparation made of multiple antigen species in Example 7 showingresponses at various m/z ratios characteristic of the various antigens;and

FIG. 14 is the mass spectrum of Example 7, showing a mass spectralresponse for the single antigen, α-cobratoxin, and demonstrating thethird qualitative mass spectrometric immunoassay strategy of the presentinvention for inferentially detecting the antibody to α-cobratoxin in aspecimen by capturing the antibody for α-cobratoxin and utilizing thisantibody in the affinity reagent.

DESCRIPTION OF PREFERRED EMBODIMENTS

The present invention relates to a new mass spectrometric immunoassayand more specifically to new and improved processes for the detectionand/or quantification of one or more antigens or antibodies in a singleimmunoassay.

The present invention can be utilized to detect and/or quantify singleor multiple antigens or antibodies in a specimen. Single terms as usedherein are meant to include plural.

In its simplest context, the present invention involves two phases:capture and isolation of an antibody analyte or antigen analyte,followed by mass spectrometric analysis of the captured antigen analyteor antibody analyte. The present invention can be used for qualitativeand/or quantitative purposes. That is, the present invention can be usedto determine whether a certain antibody or antigen is present in aspecimen (qualitative), and/or to measure the amount of the antigen orantibody present in a specimen (quantitative).

A more detailed description of the several facets of this inventionappears hereafter utilizing the following lexicon.

“Affinant” is the antibody and/or antigen which is used to make theaffinity reagent. Usually, an affinity reagent to analyze for antigenswill be made with one or several types of antibody. Similarly, anaffinity reagent to analyze for antibodies will be made with one orseveral different antigens. However, all quantitative analyses in thepresent invention require the affinity reagent to capture at least twodifferent types of molecule, one of which is the analyte, the othermolecule acting as an internal reference species. Sometimes, the analytemay be an antibody and the internal reference species an antigen, orvice versa. Where this is so, it would be necessary for the affinityreagent to contain both an antibody and an antigen. For example, becausethe number of resolvable types of antibody is small, a protein that isnot an antibody may make a useful internal reference species for anantibody, because it has a resolvable mass and a specific antibody isreadily available for it. In such a case, the affinity reagent needs tocontain an immobilized antibody having a specific affinity for thatprotein, in addition to an immobilized antigen having a specificaffinity for the antibody analyte.

“Affinity” is the ability of a molecule to bind with another moleculehaving proper fitting conformation.

“Affinity reagent” is a type of antigen or antibody immobilized to asolid substrate. Preferably, immobilization is, obtained by covalentlylinking the antigen or antibody to the solid substrate, althoughnon-covalent linkage may be acceptable. The antibody or antigen can bedirectly linked to the solid substance surface, or can be indirectlyattached to the solid substrate by linking the antibody or antigen to acoating on the solid substrate.

“Allergen” is a particulate material capable of stimulating an allergicresponse in susceptible individuals. Typically, allergens include dusts,pollens, molds, spores, and particles of insect and animal detrita. Eachtype of material may carry on its surface, many different kinds ofproteins capable of stimulating an allergic response. The allergicresponse is characterized in the human body by the production ofelevated levels of an immunoglobulin, IgE, molecular weight ˜170,000 Da,which is distinguishable from other immunoglobulins such as IgG whichhave a different molecular weight (IgG: ˜150,000 Da).

“Analyte” except as otherwise defined, is an antibody or antigen that iscaptured, isolated and mass spectrometrically analyzed for thequalitative purpose of detecting whether a specimen contains a certainantibody or certain antigen. Depending on the qualitative methodemployed, the analyte may be the certain antibody or certain antigenbeing looked for in the specimen, or may be another antibody or antigenused to indirectly detect the certain antibody or certain antigen.

“Antibody” is a protein that specifically binds with another moleculethat possesses one or more unique antigenic sites.

“Antigen” is any molecule having an antigenic site that can bind to anantibody. It is apparent that the categories of molecules that may beconsidered antigens under this definition is broad, essentially anymolecule that can bind with an antibody qualifies as an antigenincluding an allergen.

“Counterpart” when used to describe an antibody or antigen, is anantibody or antigen which has a molecular weight indistinguishable inthe mass spectrum from that of the analyte, and which gives a responseidentical to that of the analyte when both are subjected to massspectrometric immunoassay from specimens of identical concentration.

“Disassociation agent” is any active cause which disassociates orunbinds a captured analyte from the affinity reagent. A laserdesorption/ionization agent may also act as a disassociation agent.Examples of a disassociation agent include but are not limited to:addition of a buffer solution, heating, sonication, application of anelectric potential, or addition of a MALDI matrix.

“Effective amount” of affinity reagent is that amount necessary tocapture an adequate quantity of the analyte (and internal referencespecies where relevant) to achieve the desired result.

“Internal reference species” is an antibody or antigen whose specificaffinity for another antibody or antigen is exploited in the massspectrometric immunoassay for quantitative purposes. The internalreference species is captured, isolated and mass spectrometricallyanalyzed alongside the analyte.

“Laser desorption/ionization agent” is any active cause which enables ananalyte to be laser desorped/ionized. An example of a laserdesorption/ionization agent is the addition of a MALDI matrix.

“Mass spectrometrically analyzed” is analyzing the antigen analyte orantibody analyte with a mass spectrometer resulting in a massspectrometric response. Generally, a mass spectrometer is an instrumentdesigned to determine the mass-to-charge ratio of ions. For thisprocess, it is necessary for the analyte molecules to be volatilized,and ionized. The ionized molecules are then accelerated by an electricfield into the analyzing device, which separates the ions by virtue of aproperty dependent on the mass-to-charge ratio (m/z). Among theseproperties are: deflection in a magnetic field, velocity afteracceleration through a fixed electric potential drop, cyclotron orbitalfrequency in a magnetic field, and trajectory in a radio frequencyquadrupole field. Because antigens and antibodies are usually relativelylarge molecules and cannot be volatilized under ordinary massspectrometric procedures, volatilization and ionization of the antibodyor antigen usually involves some kind of assistance. One commonprocedure of assistance is known as matrix-assisted laserdesorption/ionization, or MALDI. Therefore, “mass spectrometricanalysis” is intended to include techniques that assist the massspectrometer in volatilizing and ionizing the antibody or antigenmolecules when such assistance is needed.

“Mass spectrometric mixture” is a mixture containing an antibody orantigen which can be laser desorped/ionized by a mass spectrometer.

“Mass spectrometric response” (or “Response”) is the response receivedfrom a mass spectrometer indicating whether or when an ion struck themass spectrometer's detector and whether or when no ion struck thedetector. A non-zero response at a given mass-to-charge ratio indicatesthat the material mass spectrometrically analyzed contained a givenmolecule that gave rise to the ion corresponding to the response at thatcharge-to mass ratio. It is apparent that a zero mass spectrometricresponse would indicate that the material mass spectrometricallyanalyzed either did not contain that molecule, or contained thatmolecule in levels below the limit of detection.

It is important to realize that the mass spectrometric response isdefined as a change in the level of the signal measured at the massspectrometer detector, not simply the absolute level of that signal. Insome types of mass spectrometer, and particularly in matrix-assistedlaser desorption/ionization time-of-flight mass spectrometers, there isa detectable signal, resulting in a non-zero baseline, throughout themass spectrum arising from such causes as background noise and thearrival of ions at the detector at times non-specific to theirmass/charge ratio. Thus, the mass spectrometric response for an ionspecies at a specific mass/charge ratio is defined as the change in themass spectrometer signal above this baseline signal level.

Detection of an ion at a given setting of electric and magnetic fieldstrengths, or at a given time after the ion is accelerated, iscontrolled by the mass-to-charge (mass/charge) ratio of that ion therebyproviding an accurate means of identifying the molecule that gave riseto that ion by the molecule's mass-to-charge ratio. The number of ionsthat strike the detector at a given setting, or at a given time, isindicated by the magnitude of the mass spectrometric response. A “massspectrum” is a collection of mass spectrometric responses over a rangeof mass-to-charge ratios.

A mass spectrum is commonly expressed graphically in terms of relative“intensity”, against mass-to-charge ratio (m/z). Where an ion arisesfrom a molecule present in the material being mass spectrometricallyanalyzed at or above the limit of detection, the response is expressedas mass spectral signals or peaks (signal, or peak) at the relativemass-to-charge ratio of the ion. Where the ion charge is +1, themass-to-charge ratio for that ion is equivalent to the molecular weightof the ion. Molecular weight is expressed in Daltons (Da.) and may beused interchangeably with the term mass-to-charge ratio for singlycharged ions.

The magnitude of a mass spectrometric response can be measured in termsof “intensity”, height of the response, or “integral”, the area underthe response. It is apparent that mass spectrometic response can beexpressed in a variety of tangible and intangible forms including butnot limited to signals, charts, electronic data and electric currents. Azero response, a response without magnitude, at a given mass-to-chargeratio indicates the material being mass spectrometrically analyzedeither did not contain a molecule that could give rise to an ion of thegiven mass-to-charge ratio, or did not contain that molecule at a levelat or above the level of detection.

“Modified variant” is an internal reference species which is made froman antibody or antigen analyte or a counterpart thereof, has affinityfor the same antigen or antibody as does the analyte, and produces amass spectrometric response relative to the analyte which is fixed andreadily determinable, but has a different molecular weight such that itis resolvable in the mass spectrum from the analyte.

“Non-specific affinity” is the strongly attractive interaction with abroad range of antibody or antigen species. By way of example only, thesubstance Protein A has a strong affinity for all antibodies of the IgGfamily.

“Normalize” or any form of the word, is that procedure for correctingmass spectra for differences in instrument performance during massspectrometric immunoassay of multiple analytical systems. In essence,normalization provides for accurate results when two immunoassays arecompared in the quantitative strategies of the present invention.Normalization is preferably achieved with the assistance of an internalreference species, but conceivably can be achieved without theassistance of an internal reference species if instrument parameters arecarefully controlled so as to be identical in the mass spectrometricimmunoassay of multiple analytical systems. Alternatively, if thedependence on the instrument parameters of the mass spectrometricresponse to a given analyte concentration is sufficiently well known,the mass spectrometric response may be corrected for the effects ofchanging instrument parameters.

“Post-combination affinity reagent” is an affinity reagent which hasbeen allowed to bind with its target antigen or antibody.

“Preparation” is an operator created substance or material and used fora particular purpose in the mass spectrometric immunoassay. The term isused to distinguish it from the specimen. Under one method of thepresent invention, material containing a counterpart antigen is createdfor the purpose of determining whether a certain antibody species ispresent in a specimen, such as antiserum, and is termed the“preparation” to distinguish it from the specimen and avoid confusion indescribing the method. Under several quantitative methods, a materialcontaining a counterpart antigen or antibody is created and termed the“preparation” and used in the quantification methods.

“Solid substrate” is defined as any physically separate solid to whichan antibody or antigen can be directly or indirectly attached includingbut not limited to agarose beads, nylon, metals, glass, silicon, andorganic membranes.

“Specific affinity” is the strongly attractive interaction betweenspecific antigens and their corresponding antibodies. The selectiveattraction between an antigen and its corresponding antibody occursbetween the antigenic site, or epitope, of the antigen and a recognitionregion in the antibody. As such, it may be possible to modify an antigenby altering its molecular weight, without noticeably altering theepitope, so that the modified antigen also has a specific affinity forthe same antibody as the unmodified antigen. An antibody may similarlybe modified without eliminating its specific affinity for its antigen.The high specific affinity between antigens and antibodies is the key tothe selective capture and isolation of a specified antigen or antibodyin an immunoassay.

“Specimen” is any material which is the focus of the mass spectrometricimmunoassay. Frequently the specimen will be of biological origin, forexample a blood sample, and contain analytes that are similarly ofbiological origin, for example peptides, proteins and antibodies.However, it is possible that the specimen may be non-biological inorigin, for example a groundwater specimen, and the analyte similarlymay be of non-biological origin, for example a pesticide. All that isnecessary for a successful immunoassay is that it should be possible toprepare an antibody having a specific affinity for that analyte.

“Unbound remainder” is whatever is left after the affinity reagentscreens the specimen.

The “mass spectrometrically immunoassay” is that procedure in which aspecimen is incubated with an affinity reagent which will specificallycapture an analyte, for a time sufficient for the affinity reagent tobind a detectable fraction of the analyte, creating a post-combinationaffinity reagent. The post-combination affinity reagent is thenseparated from the unbound remainder of the specimen sample to isolatethe captured antigen from the unbound remainder. Preferably, theisolated post combination affinity reagent is then washed to remove anyunbound remainder adhering to the isolated affinity reagent.

A laser desorption/ionization agent is then added to isolated postcombination affinity reagent to unbind any antigen bound to the affinantand form a mass spectrometric mixture from which the unbound antigen isthen mass spectrometrically analyzed. If the specimen contained thecertain antigen at a level above the detection limit of the massspectrometric immunoassay process for that antigen, the resulting massspectrum will show a mass spectral signal at the unique mass-to-chargeratio of the certain antigen. If the specimen did not contain thecertain antigen at a level above the detection limit of the massspectrometric immunoassay process for that antigen, no such signal willbe evident.

Such a mass spectrometric immunoassay procedure can result in aqualitative or a quantitative analysis, depending on whether or not aquantification method is used.

A multitude of qualitative and quantitative methods are possible usingthe present invention. Below three qualitative methods are discussed indetail, followed by a detailed discussion of six quantification methods.The mass spectrometric immunoassay of the present invention is verysensitive and requires only very small quantities of analyte and/orsmall volumes of analyte containing samples. The detection limit isapproximately between 1×10⁹ and 1×10¹⁰ analyte molecules in about 200 μL(microliters) of sample.

The first qualitative strategy is designed to determine whether one ormore antigens are present in or are absent from a specimen. Antibodiesto each antigen to be detected are immobilized on a solid substratecreating the affinity reagent. The affinity reagent is then incubatedwith the specimen to screen the specimen for any antigen present in thespecimen that has an affinity for the affinant-antibody immobilized onthe affinity reagent. Screening in this context means to combine thespecimen and affinity reagent for enough time to allow theaffinant-antibody to combine with a detectable amount of antigen forwhich it has a specific affinity. The affinity reagent will capture someor all of the antigen present in the specimen, if any. Thepost-combination affinity reagent is then separated from the unboundremainder of the specimen to isolate the captured antigen from theunbound remainder. Preferably, the isolated post-combination affinityreagent is then washed to remove any unbound remainder adhering to theisolated affinity reagent.

A disassociation agent is applied to the post-combination affinityreagent to disrupt the antibody-antigen binding and produce a solutioncontaining free antigen which can be separated from the solid affinityreagent by filtering. If the mass spectrometric analysis is to beperformed using matrix-assisted laser desorption/ionization (MALDI), thesample must be combined with an excess amount of a laserdesorption/ionization agent (known otherwise as a “MALDI matrix”) andallowed to crystallize by drying. In general the MALDI matrix materialswhich are effective laser desorption/ionization agents are alsoremarkably effective disassociation agents, and disassociation usingthese materials is preferred, in particular because the process ofdisassociation and creation of a mass spectrometric mixture is therebymade simple and rapid.

The solution resulting from the disassociation step may be massspectrometrically analyzed. If the solution is to be analyzed usingmatrix-assisted laser desorption/ionization mass spectrometry, it mustfirst be combined with a MALDI matrix if such a matrix material was notused as a disassociation agent. If the specimen contained one or more ofthe antigen species for which the affinity reagent has a specificaffinity, at a level above the detection limit of the mass spectrometricimmunoassay process for that antigen, the resulting mass spectrum willshow a mass spectral signal at the unique mass-to-charge ratio of thecertain antigen. If the specimen did not contain the certain antigen ata level above the detection limit of the mass spectrometric immunoassayprocess for that antigen, no such signal will be evident. This strategymay be used to screen specimens for as many discrete antigen species ascan be distinguished from each other in a single mass spectrum. In theevent that more antigens must be searched for than can be distinguishedin a single mass spectrum, two or more affinity reagents must becreated, each having affinities to different sets of distinguishableantigens.

The procedures for the second qualitative strategy under the presentinvention are similar to the first except the affinity reagent is madewith antigens seeking antibodies. The analyte is an antibody. The samegeneral protocols apply. An antigen known to have a specific affinityfor the antibody analyte is immobilized to a solid substrate. Theaffinity reagent is incubated with the specimen being assayed for thedesired antibody and allowed to capture the antibody for which it has aspecific affinity. After washing the reagent any captured antibody isisolated from the specimen environment. A disassociation agent then alaser desorption/ionization is added to the isolated antibody to free itfrom the substrate and facilitate ionization prior to mass spectrometricanalysis. Alternately, only the laser desorption/ionization agent can beadded without the disassociation agent to the isolated antibody analyte.A mass spectral response at the molecular weight (same as single chargedm/z) of the target antibody evidences the presence of the antibody inthe specimen.

In addition to using pure antigens to capture specific antibodies, itcan also be useful to use impure antigens to capture classes ofantibodies. Such a situation arises in testing for allergies, in whichwhole allergen particles, such as dusts, pollens, molds, spores andparticles of insect and animal detrita, may be covalently anchored to asolid substrate, or even used without such anchoring if the particlesare sufficiently large to be separated by filtering may be used tosearch for elevated levels of an antibody, IgE, which is produced aspart of the allergic response. IgE has a molecular weight of ˜170,000Da, sufficiently different from that of IgG, another major antigenicantibody class with a molecular weight ˜150,000 Da, that IgE and IgG aredistinguishable in a mass spectrometer. However, like other antibodies,individual types of IgE molecules are not resolvable from each other.Accordingly, determination of which of several possible allergens has aspecific affinity for IgE in a blood sample would necessarily use asingle species of allergen, for example, the pollen of a specific plant,such as ragweed, to screen a specimen for IgE characteristic of allergyto ragweed pollen, and separate screening procedures would be carriedout for each specific allergen. Small molecules, such as drugs, do notstimulate an allergic response when present alone, but do so effectivelywhen bound to proteins to form conjugates. Screening forlife-threatening sensitivity to drugs therefore would necessarily useaffinity reagents in which the drug molecules in question were attachedto proteins incorporated in the affinity reagent.

The advantage of such screening over the conventional skin and patchtests for allergy is not only its enhanced speed but, equally important,the ability to avoid a potentially catastrophic hyperallergenic reactionthat could occur when the patient is used as an allergy detector.

Because antibodies within a certain class, such as immunoglobulin G(IgG) do not vary in molecular weight by a sufficient amount to bedistinguishable mass spectrometrically, a different strategy must beadopted to screen a specimen for specific types of similar antibodies,for example, antibodies belonging to the IgG class. In this strategydetection of a specific antibody is indirect. A specimen is combinedwith a solid substrate having a broad non-specific affinity forantibodies. A representative sample of the antibody population in thespecimen will bind with the solid substrate creating an affinityreagent. The affinity reagent is then incubated with a screeningpreparation made with an antigen or antigens known to have a specificaffinity for the antibody or antibodies to be searched for. If a certainantibody is a member of the antibody population on the affinity reagent,and the specific antigen to that antibody is present in the screeningpreparation, then that antibody will capture its specific known antigenfrom the preparation. The affinity reagent is then separated from thepreparation leaving behind the unbound remainder. Preferably, theisolated affinity reagent is washed to remove any unbound remainderadhering thereto.

A laser desorption/ionization agent is then applied to the isolatedaffinity reagent to unbind any antigen bound to the affinant-antibodyforming a mass spectrometric mixture from which the unbound antigen isthen mass spectrometrically analyzed. A mass spectral signal at theunique mass-to-charge ratio of a known antigen indicates the antibodyspecific for that antigen was present in the specimen. Absence of a massspectral signal indicates that the certain antibody was not present inthe specimen at or above the detectable limit.

The preferred incubation method for all three qualitative methods isarrived at empirically and depends on the given analytical system.Generally, incubation can be stationary (combining the affinity reagentand sample then agitating), flowing (one-time or repetitive flowing ofsample over the affinity reagent), or accelerated by the application ofan electrical potential across the sample solution. Because the use ofan internal reference species serves to calibrate variables in theincubation process as well as in the mass spectrometric analysis, it isnot necessary to ensure that incubation proceeds to equilibrium toachieve accurate analyses. Rapid incubations and consequently rapidanalyses are therefore possible under the present invention.

Preferably, the disassociation agent and laser desorption/ionizationagent chosen is arrived at empirically, however, the preferred agent isoften the addition of any material commonly referred to as a “MALDImatrix” by those in the field of mass spectrometry. Examples of commonlyused MALDI matrix materials can be found in: Fan Xiang and Ronald C.Beavis, Rapid Communications in Mass Spectrometry, vol. 8, pp. 199-204,1994 and in Ronald C. Beavis, Organic Mass Spectrometry, vol. 27, pp.653-659, 1992.

Because an unbound antigen analyte or unbound antibody analyte istypically too large a molecule to be ionized, the unbound analyte cannotordinarily be mass spectrally analyzed without additional preparatorytechniques. Preferably, matrix assisted laser desorption/ionization(MALDI) techniques enable mass spectrometric analysis of the analyte.Standard MALDI protocols can be found in Ronald C. Beavis, Organic MassSpectrometry, vol. 27, pp. 653-659, 1992.

The mass spectrometer used in the present invention can be any massspectrometer that will analyze the analytes including a magnetic sectormass spectrometer, a Fourier transform ion cyclotron resonance (FTICR)mass spectrometer, a quadrupole ion trap mass spectrometer and anytime-of-flight (TOF) mass spectrometer. Of these the TOF massspectrometer is preferred.

Mass spectrometric analysis of the captured, isolated and unboundanalyte results in an analyte mass spectral signal at the mass-to-chargeratio characteristic of the analyte. The location of the signal on themass spectrum is dependent on the molecular weight of the analyte,thereby providing a reliable means for identifying the analyte. The massspectral signal also has magnitude. The magnitude of the signal isindicative of the amount of analyte that is ionized and detected by themass spectrometer. Mass spectrometric signal magnitude has at least twodimensions that are directly measurable, intensity or height of thesignal, and integral or the area under the signal. Either the intensityor the integral can be used to quantify.

The mass spectrometric immunoassay process can also be designed toquantify an antibody or antigen present in a specimen. All suchquantitative analyses utilize standard preparations containing knownconcentrations of the analyte for calibration. In addition, because itis difficult to control the analytical conditions sufficiently well toensure a constant absolute mass spectrometric response for a constantanalyte concentration in different samples, quantitative analysis usingthe present invention relies on the presence of or the introduction ofat least one internal reference species in the analytical system priorto incubation with the affinity reagent. The internal reference speciescan be added to the analytical system being assayed, or be intrinsicthereto. It is captured, isolated and mass spectrometrically analyzedsimultaneously with the analyte, thereby serving to calibrate theanalytical conditions from one analysis to another because both analyteand internal reference species respond identically to changes in theseconditions.

The affinity reagent must contain an affinant that will specificallycapture or bind with the internal reference species. It is essentialthat the internal reference species have a molecular weight sufficientlydifferent from that of the analyte or analytes that it can be resolvedin the mass spectrum from the signals arising from the analyte oranalytes. However, the molecular weight difference is preferably theminimum necessary for resolution in the mass spectrum, because analytesdiffering very greatly in mass may not respond identically to changes inthe mass spectrometer operating conditions. Preferably, the internalreference species is a modified variant of the analyte. Where a modifiedvariant is used as the internal reference species, an affinant that cancapture the analyte can usually also capture the modified variantbecause the modification shifts the molecular weight of the antibody orantigen without destroying its affinity. Where the internal referencespecies is not a modified variant of the analyte, another immunochemicalaffinity group must be present in the affinity reagent in order tosimultaneously capture and isolate that internal reference speciesalongside the analyte. It is possible, and may be desirable, for aprotein that is not an antibody to be used as an internal referencestandard in an analysis of an antibody species. In such a situation, theaffinity reagent would be prepared with two classes of molecules, anantibody specific for the protein and an antigen for which the analyteis specific.

The number of internal reference species employed also depends on thequantification method employed. The working curve or single pointquantification approaches require at least one internal referencespecies present in the analytical system. The bargraph quantificationapproach requires several internal reference species.

The internal reference species in a quantification method serves tworoles: 1) the role of a normalizer, and 2) the role of a concentrationindicator. There is more than one possible strategy or method forquantification of an antigen or antibody under each of these roles.

The internal reference species serves to correct for differences inaffinity reagent activity or concentration, for differences inincubation times for different samples, and for differences in massspectrometer performance during the mass spectrometric immunoassay ofmultiple samples, thereby ensuring accurate quantification. However,because all mass spectrometric responses are thereby determined relativeto the internal reference species response, this internal referencespecies signal also serves as a concentration indicator, that is, theinternal reference species signal for a given concentration of thatspecies is calibrated by various strategies so as to indicate a givenconcentration of the analyte species.

Quantification strategies all involve mass spectrometric immunoassay ofat least two separate analytical systems. In most of the quantitativestrategies, one analytical system contains the specimen, and the other apreparation containing the antibody or antigen analyte or a counterpartthereof in known concentration, or in a concentration which has beenaltered by a known amount by adding a known amount of the analyte whereboth the specimen and the preparation contain the same internalreference species in known concentration, preferably the same.

Normalizing with an internal reference species can be accomplished intwo basic ways, that is, during mass spectrometric analysis or after.Both methods require the analytical samples to contain the same internalreference species. For normalizing during mass spectrometric analyses,the mass spectrometer is adjusted so as to bring the internal referencespecies signals of each immunoassay to a value proportional to theconcentration of the internal reference species. Most conveniently, theinternal reference species concentrations in all the analytical samplesare the same, and the mass spectrometer is adjusted to bring allinternal reference species signals to the same value. For normalizingafter mass spectrometric analyses, the mass spectrum for each assay isdivided or multiplied by an appropriate factor, again to bring theinternal reference species mass spectral responses to a valueproportional to the concentration of the internal reference species. Thesecond procedure is preferred. The result is to normalize all massspectral responses or signals, and all affinity capture procedures toone standard thereby artificially, or in practice, making instrumentperformance and affinity capture procedures in each of the immunoassaysthe same. The working curve strategy, standard addition strategy, singlepoint calibration strategy, and the bargraph strategy are allquantification strategies under the present invention that employ one ormore internal reference species as both a normalizer and a concentrationindicator.

Although it is preferred that the normalization of mass spectra beachieved where the internal reference species concentration in eachanalytical sample being mass spectrometrically assayed is the same ineach analytical sample, it is possible to normalize multiple massspectra with analytical samples containing the same internal referencespecies in different, but known concentrations. To normalize under theseconditions a scale is determined for the magnitude of that internalreference species mass spectral response and that scale is used tonormalize the other mass spectra. By way of illustration only, supposesample A contains the internal reference species, I-A, in concentrationof 100, and sample B contains the same internal reference species,termed I-B to distinguish from A's internal reference species, inconcentration of 50. After mass spectrometric immunoassay of A and B,the mass spectral signal for I-A is adjusted to fit an intensity of one(normalized intensity), the other mass spectral signals in A's massspectrum are also adjusted so as to be in the same original proportion(in intensity) to the adjusted I-A signal as they were for the initialI-A signal. Because the concentration of I-B is half the concentrationof I-A, the mass spectral signal for I-B then adjusted to fit anormalized intensity of 0.5. The other mass spectral signals in B'sspectrum are also adjusted so as to be in the same original proportion(in intensity) to the adjusted I-B signal as they were for the initialI-B signal. Preferably, all spectra adjustments are accomplished withthe aid of computer data manipulation software such as LABCALC, producedby Galactic Industries, Salem, N.H.

For accurate normalization and/or calibration using an internalreference species the absolute amplitudes of the mass spectrometricsignals for the analyte and internal reference species should besimilar. If these two signals differ by a large factor, for example by afactor of several hundred, it will not be possible to measure bothsignals accurately in the same mass spectrum because the detectionsystem cannot respond accurately to signals differing by so large afactor, i.e., the dynamic range is limited. For example, in thetime-of-flight mass spectrometers which are the preferred devices forobtaining mass spectra of laser-desorped ions in the present invention,the signal from the mass spectrometer must typically be digitized, thatis, converted to a binary number suitable for transfer to a computermemory, at successive time intervals as short as 5-10 nanoseconds. Thedigitization circuitry typically converts the signal to a binary numberhaving a value between 0 and 256. If a 1 volt signal, for example,corresponded to the digital value of 256, then all signals larger than 1volt would also be registered as 256 and the system would have noability to measure any such signals accurately. Conversely, in theabsence of any electronic noise, all signals lower than 1/256 voltswould be registered as 0 and again the measurement would be inaccurate.Low signals above 1/256 volt are also measured inaccurately because thebinary scale is coarse and because of noise effects. Preferably, theabsolute amplitudes of the mass spectrometric signals for the analyteand internal reference species should differ by less than a factor often, and the mass spectrometer is adjusted to bring the more intensesignal near the allowable maximum.

The mass spectral signal of an internal reference species is typicallyused to directly quantify an analyte by comparing the internal referencespecies signal to the analyte signal, after the internal referencespecies signal has been calibrated by a working curve or standardaddition approach.

It is apparent that given the high specificity of affinity capture andisolation, and of mass spectrometry, quantification strategies can beemployed to quantify multiple antigens or antibodies in the samespecimen. It is also apparent that it is possible to employ multiplequantification strategies in a given assay to quantify single ormultiple antibodies or antigens.

Detailed Quantification Methods Using the First and Second QualitativeMass Spectrometric Methods

Below is a detailed description of each of the quantification strategiesas employed with the first and second qualitative mass spectrometricimmunoassay methods.

It is apparent that, because analytical parameters may vary, includingdifferences in affinity reagent activity or concentration, differencesin incubation times for different samples, differences in elutionefficiency, and differences in mass spectrometer performance during themass spectrometric immunoassay of multiple specimens, therefore theabsolute intensity of the mass spectrometric response for a givenanalyte in a given analysis cannot be used to derive a concentration forthat analyte. Instead, an internal reference species (IRS), which ispreferably captured by the same affinity reagent during the sameincubation time, eluted under identical conditions and massspectrometrically analyzed under identical conditions, serves tocalibrate all of these variables at one time. All analyte signals aretherefore determined as ratios to the respective IRS signals. When thisis done it is possible also to calibrate the analysis by determining theanalyte/IRS signal ratio for a known concentration ratio of analyte andIRS in an analytical sample. The methods for accomplishing thiscalibration are known as the working curve approach, the standardaddition approach, and the single point calibration approach, and areused here exactly as in standard analytical chemistry procedures.

The working curve approach is developed in anticipation of the fact thatgenerally the analyte concentration encountered in an analysis will notbe identical to the analyte concentration used to calibrate the IRSsignal. There are two possible approaches.

a) It may be assumed that the relationship between analyte/IRSconcentration ratio and analyte/IRS signal ratio is accurately linear.Then, for example, if the analyte/IRS signal ratio is 2:1 for equalconcentrations of analyte and IRS, an analyte/IRS signal ratio of 4:1signals an analyte concentration exactly twice the known IRSconcentration in the sample. It is usually safe to assume that such alinear assumption may hold, with an accuracy of approximately 10% orbetter, for analyte/IRS concentration ratios between approximately ⅓ and3 times the ratio at which the original calibration was performed (i.e.,over about a factor of 10 in concentration). When this assumption oflinearity is valid, the relationship between analyte concentration andinternal reference mass spectrometric response may be determined using asingle calibration sample and this approach is known herein as thesingle point calibration method.

By way of illustration, suppose signal A for analyte A of knownconcentration 1000 has a magnitude of 10 units, and signal B for analyteB of unknown concentration has a magnitude of 7.2 units, and it is knownfrom prior calibration that equal concentrations of both analytes willyield equal mass spectral signals. In calibrating A's signal, each unitof A's magnitude represents a concentration of 1000/10 or 100. AnalyteB's concentration is therefore 7.2×100 or 720 units. If equalconcentrations of A and B yield different mass spectral responses thecalibration must include the ratio of the mass spectral responses. Forexample, if the mass spectral signal for a given concentration of A were½ the mass spectral signal for the same concentration of B, then theconcentration of B corresponding to a signal magnitude of 7.2 units inthe above example would be 720/2 units, or 360 units.

For simple ratio quantification of analytes in separate specimens, thespecimens (with internal reference species present) are each massspectrometrically immunoassayed with an affinity reagent having anaffinity for each antigen or antibody being looked for in the relevantspecimen, and for the internal reference species. The resulting massspectra are normalized using the internal reference species signals thenthe signal of the analyte of unknown concentration is calibrated againstthe signal of the analyte of known concentration as described in thehypothetical example above.

b) For situations where the analyte/IRS concentration ratio is expectedto vary over more than a factor of 10, or where the relationship isexpected to be non-linear, or where greater accuracy is required, therelationship between analyte/IRS concentration ratio and analyte/IRSsignal ratio may be determined over as large a range as desired bymaking a series of preparations with varying analyte/IRS concentrationratios in which the analyte concentrations span the expected analyteconcentration range. The greater the number of preparations, the moreaccurately the relationship between analyte/IRS signal ratio and analyteconcentration will be determined. The antibody or antigen analyte usedto make the preparations is generically termed the preparation analyte,or specifically termed the preparation antigen or preparation antibody.The preparations either contain the same internal reference species inthe same concentration as the specimen, or a concentration knownrelative to that in the specimen. After subjecting each sample to massspectrometric immunoassay, the ratios of the analyte mass spectrometricresponses to the corresponding internal reference species massspectrometric responses are plotted as a function of the known ratios ofthe analyte/internal reference species concentrations for each sample.The resulting relationship, or working curve, may be expressed in avariety of ways, including, but not limited to, a graph, a mathematicalrelationship or computerized data.

If the analyte (antigen or antibody) is present in the specimen, asevidenced by an analyte mass spectral signal on the specimen massspectrum, then the analyte can be quantified by locating the point onthe working curve relationship (ultimately a mathematical relationship)appertaining to the magnitude of the analyte/IRS signal ratio anddetermining the analyte concentration that corresponds to that point,given the known IRS concentration.

As an alternative to the generation of a working curve spanning a widerange of analyte concentrations, over which the working curverelationship might be expected to be non-linear, or for extremely rapiddetermination of analyte concentrations directly from the mass spectrum,a unique bargraph quantification method may be used. The bargraphquantification method requires the presence of several distinct internalreference species in the analytical sample, each at a different andknown concentration and differing in mass from the certain antigen orantibody and each other sufficiently to be distinguishable in the massspectrum. Because the concentrations of the internal reference speciesmust be known, the internal reference species are typically added to thespecimen, not intrinsic thereto. Mass spectrometric immunoassay of thespecimen is then executed using an affinity reagent having specificaffinity for each internal reference species and for the certainantibody or certain antigen being looked for in the specimen. Theresulting mass spectrum will contain a mass spectral signal for eachinternal reference species and a mass spectral signal for the certainantigen or certain antibody, if present.

Preferably, the internal reference species are all modified variants ofthe analyte being mass spectrometrically immunoassayed so that theinternal reference species are capable of being captured by a singleaffinant, and the mass spectral signals all neighbor one another on themass spectrum. Each distinct internal reference species must have amolecular weight sufficiently different from the other internalreference species so as to be resolvable in a single mass spectrum. Inaddition, it is preferable that the range of concentrations covered bythe internal reference species span the concentration range in which theanalyte is reasonably expected to be found. It is not necessary that thedifferent internal reference species be captured by the affinity reagentwith the same efficiency as either the analyte or each other; thedifferent internal reference species are each simply added to theanalytical sample at concentrations which produce mass spectral signalsthat have the same amplitude as the signal that would be produced by aknown concentration of the analyte.

With this bargraph mass spectrum, the analyte can be quantified in atleast three ways: 1) by interpolating the analyte's mass spectral signalmagnitude to the magnitude of the internal reference species massspectral signal immediately above and below the analyte mass spectralsignal, normally assuming a linear relationship between signal andconcentration in this range, or 2) by estimating the analyteconcentration by simple visual comparison of the analyte mass spectralsignal and the nearest internal reference species signal (in magnitude)without computation, or 3) by certifying that the analyte signal, andtherefore the analyte concentration, is above or below the signal leveldue to a reference species corresponding to a previously determinedanalyte concentration. This previously determined analyte concentrationmay be chosen to specify the presence or absence of a specific diseaseor condition. Since, under the bargraph strategy, the analyte is thecertain antigen or certain antibody present in the specimen, thequantification of the analyte directly quantifies the certain antibodyor certain antigen. The advantage of the bargraph approach is apparentin that the calibration scale is built into the mass spectrum givingexceptional immunity to instrumental and sample variations, andextremely rapid direct readout. For the most accurate analysis strategy(1) above is used, and the accuracy of this approach may be improved asnecessary either by choosing the internal reference speciesconcentrations to produce mass spectral signals which are closely spacedand near the analyte mass spectral signal, or by calibrating the analyteconcentration range between those analyte concentration values specifiedby the internal reference species signals by using a number of standardpreparations containing analyte concentrations within the concentrationrange to be calibrated.

The standard addition approach is another strategy for determining therelationship between the analyte/IRS signal ratio and the analyte/IRSconcentration ratio. In this approach, separate calibration preparationsare not required. Instead the effect on the analyte/IRS signal ratio ofchanging the concentration of the analyte in the analytical sample by aknown amount is determined. Most directly, the analytical sample, towhich an internal reference species has been added, is divided intoseveral divided samples, at a minimum two. The first divided sample ismass spectrometrically immunoassayed and an analyte/IRS signal ratiodetermined from the resulting addition-absent mass spectrum. To theother divided sample or samples various known amounts of the analyte, oran analyte counterpart, are added to increase the concentrations of theanalyte, or the analyte counterpart, by various known amounts. Thesesamples similarly are mass spectrometrically immunoassayed resulting ina series of addition-present mass spectra from which the analyte/IRSsignal ratios are determined.

The analyte/IRS signal ratios in the addition-present mass spectra arethen used to determine the analyte concentration in the addition-absentsample. This is preferably done by using the addition-presentanalyte/IRS signal ratios closest in magnitude to the addition-absentanalyte/IRS signal ratio to establish a mathematical relationshipbetween changes in magnitude of the analyte/IRS signal ratio and thecorresponding concentration change in the antibody or antigen due to thestandard addition. This mathematical relationship may be expressed in avariety of ways, including but not limited to a line, a mathematicalfunction, a graph, or computerized data. The standard additionmathematical relationship is then extrapolated to the intercept pointfor zero mass spectrometric response. The intercept point's value forstandard addition concentration will be in negative units. The absolutevalue of this value inferentially represents the concentration of theanalyte in the specimen.

Less preferably, a standard addition analysis may be performed in serialfashion without dividing the original sample. In this approach, theanalytical sample, to which an internal reference species has beenadded, is mass spectrometrically immunoassayed using an incubationprocedure designed to capture only a small fraction (for example, lessthan 5%) of the analyte and IRS, and an analyte/IRS signal ratiodetermined for this addition-absent sample. A known amount of analyte,or an analyte counterpart, is added to the original sample, increasingthe concentration of the analyte, or analyte counterpart, by a knownamount, and again the sample is mass spectrometrically immunoassayedusing an incubation procedure designed to capture only a small fraction(for example, less than 5%) of the analyte and IRS. An analyte/IRSsignal ratio is similarly determined for this addition-present sample.Further addition-present samples may be prepared by increasing theconcentration of the analyte or analyte counterpart by further knownamounts and these samples may be similarly mass spectrometricallyimmunoassayed to determine further analyte/IRS signal ratios.

The analyte/IRS signal ratios in the addition-present mass spectralsignals are then used to determine the analyte concentration in theaddition-absent sample exactly as in the parallel standard additionapproach. Since mass spectrometric immunoassay of each addition-presentsample serves to calibrate a sample in which the concentration of theanalyte differs from the analyte concentration in the addition-freesample by an amount which depends on the amounts of analyte captured inthe preceding mass spectrometric immunoassays, it is apparent that theaccuracy of this procedure will only be acceptable if the amount ofanalyte captured in each successive step is small, for example if 5% ofthe analyte is captured in the mass spectrometric immunoassay of theaddition-free sample and mass spectrometric immunoassay of a singleaddition-present sample is performed, the analyte concentrationdetermined thereby would be in error by 5%.

The relative signal approach compares two analyte signals to each otherwhere the concentrations of the analytes in the specimens are unknown.Often times the precise concentration of an antibody or antigen is notthe information needed. Rather, knowing whether the antibody or antigenis present in levels at, below, or above the level of another antibodyor antigen is what is needed. It is irrelevant whether a numericalfigure is reached because only the relative relationship matters. Tocompare two or more analyte concentrations to each other by means oftheir mass spectrometric immunoassay responses, it is necessary only toknow the relative response of the analytical process to each analyte,i.e., the relative amplitude of the mass spectrometric signals when eachanalyte is present in a calibration sample at identical concentrations(or at a concentration ratio which is known). In this strategy, aseparate internal reference species is not required because each analyteserves to normalize the other, i.e., both analytes are subjected toidentical affinity capture procedures and to identical massspectrometric procedures.

The relative signal and simple ratio quantification methods share somesimilarities. Both compare the mass spectral signals of one analyte toanother analyte. The two analytes can originate from one specimen, thusinvolving only one mass spectrum, or can each originate from separatespecimens, thus involving two mass spectra. It is not necessary that theanalytes have identical molar responses, i.e., affinity constants anddesorption/ionization efficiencies.

It is apparent that either approach can be used for the quantificationof more than two analytes and/or involve more than two specimens. It isalso apparent that the analytes from multiple samples may be the sametype of analyte, or different. Therefore, the following descriptions aremeant to include multiple specimens and/or multiple analyteimmunoassays.

When two or more specimens are involved, both the simple ratio andrelative signal quantification methods require that an internalreference species be present in each specimen sample in the sameconcentration to normalize the mass spectra. If one specimen is used,signals for the two analytes must be distinguishable in the massspectrum, and no normalizing internal reference species is necessary. Itis apparent that the two analytes whose mass spectral signals are beingcompared in a single sample are used to quantify either or both of theanalytes and are essentially acting as analyte and an internal referencespecies, i.e., in qualitative and quantitative capacities at the sametime. Therefore, to avoid confusion of terms, “internal referencespecies” is used in connection with the relative signal and simple ratioquantification methods to mean the antibody or antigen occupying thenormalizer role. An “analyte” is used to mean the antigen or antibodyacting in both a qualitative and quantitative role.

For relative signal quantification of analytes in separate specimens,the specimens (with internal reference species present) are each massspectrometrically immunoassayed with an affinity reagent having anaffinity for each antigen or antibody being looked for in that specimen.The resulting spectra are normalized, then a comparison of the analytesignals made to determine which analyte is of greater or lesserconcentration. By way of illustration only, suppose two blood samplesfrom the same person taken at different times are mass spectrometricallyimmunoassayed to determine whether there is a change in the level ofantigen X. Affinity reagent having an affinity for antigen X would beused in the mass spectrometric immunoassay of both samples. The two massspectra would each show a mass spectral signal for antigen X and theinternal reference species. After normalizing the spectra, the twoantigen X signals could be compared to see if the level of antigen X haddropped or risen in the intervening time between taking the samples. Theabsolute concentration of X in either sample can not be determinedwithout further calibration, but the amplitude of the relative changemay be determined.

In the simple ratio quantification strategy, two analyte mass spectralsignals are compared where one of the analyte signals originates from aspecimen where that analyte's concentration is known. Unlike therelative signal method above, a numerical quantification results. Theunknown concentration analyte signal is calibrated against the knownanalyte mass spectral signal to determine the concentration of theunknown analyte in that specimen.

For simple ratio quantification of two analytes in the same specimen,the specimen is mass spectrometrically immunoassayed with an affinityreagent having an affinity for each antigen or antibody being looked forin that specimen. The resulting mass spectrum will contain a signal foreach analyte which was present in the specimen. Where two signalsresult, calibration of the magnitude of the signal corresponding to theanalyte of known concentration to the magnitude of the signal of theanalyte of unknown concentration determines the concentration of theother.

To further aid in the understanding of the present invention, and not byway of limitation, the following examples are presented:

EXAMPLE 1

In one practice of the present invention, a single analyte, myotoxin a,was detected in human whole blood using the affinant, anti-myotoxin a,as a constituent of the affinity reagent, and then quantified using aworking curve strategy. Myotoxin a is one toxin found in the venom ofthe prairie rattlesnake, Crotalus viridis viridis (C. v. viridis).

The antibody, anti-myotoxin a immunoglobulin IgG affinity purified fromrabbit antiserum, was used to prepare the affinity reagent as follows.One milliliter of antibody solution (the solution contained the antibodyat 5 mg/mL in 0.01M tris[Hydroxymethyl] aminomethane, pH 8.2 (tris)) wasincubated for two hours (gentle agitation at room temperature) with 1 mLof slurried 6% agarose beads on which protein A was supported. Followingincubation, the beads were washed (3×1 mL tris) and allowed to react atroom temperature with 500 μL of 0.02 M dimethylpirnelimidatedihydrochloride prepared in 0.2 M triethanolamine (pH 8.2). The reactionwas stopped after one hour by washing (3×1 mL) with 0.2 Mtriethanolamine followed by one milliliter 0.2 M sodium citrate buffer(pH 2.8). The reagent was finally washed (3×1 mL) with Iris andresuspended in 500 μL of the same buffer.

Stock human blood (SB) was prepared after intravenous retrieval byimmediately diluting to ten times volume with normal saline to preventcoagulation. Three specimens were prepared from this diluted stock bloodby combining 50 μL SB, 150 μL Iris and 2 μL aliquot of C.v.viridis venomat a concentration of 0.2 mg/Ml (resulting after dilution in aconcentration of 0.002 mg/mL venom).

An internal reference species for the quantification of myotoxin a wasprepared by lysine conversion of myotoxin a to homoarginine (H-myotoxina). The lysine modification was carried out as follows: myotoxin a(final concentration=10 mg/mL) was dissolved in 0.5 M O-methylisourea,which was adjusted to pH 11.0 with 8.0 M NaOH. The solution wasincubated at 4° C. for 120 hours. The reaction was stopped by additionof an equal volume of 1 M sodium dihydrogen phosphate at pH 5.0. Themixture was then desalted with an Amicon ultracentrifugation devicefitted with a PM-2 membrane filter at 4° C. The resulting solution waslyophilized and stored for future use in a desiccator at −20° C. Themodification resulted in the conversion of each of the ten lysineresidues to a guanidinium group, giving a total shift in mass of 420 Da.

Three microliter aliquots of slurried affinity reagent were incubatedfor 45 minutes with a 200 μL volume of the specimen containing 0.002mg/mL whole venom and 40 nM (nanomolar) H-myotoxin a. The affinityreagent, now containing myotoxin a affinity bound to the retainedanti-myotoxin a, was then physically separated from the specimen byforcing the entire 200 μL (microliter) volume through the backside of aP-10, 10 μL filter pipette tip thereby retaining the affinity reagent onthe filter. The affinity reagent was then washed by forcing rinses (2×1mL 0.1% Triton X-100, 2×1 mL tris, 1 mL triply-distilled water) throughthe P-10 tip.

After the final rinse, four microliters of the MALDI matrix, ACCA(α-cyano-4-hydroxycinnamic acid saturated in 1:2, acetonitrile:1.33%,aqueous trifluoroacetic acid), was drawn through the P-10 tips and overthe retained affinity reagent thereby disassociating and enabling laserdesorption/ionization of the myotoxin a and H-myotoxin a. The wholevolume was then immediately driven out of the P-10 tip and placeddirectly onto a mass spectrometer probe tip and allowed to air-drybefore insertion into the vacuum system of the mass spectrometer. Thetime required for sample preparation was approximately one hour.

Matrix-assisted laser desorption/ionization time-of-flight massspectrometry of the dried material on the mass spectrometer probe tipwas then performed on a linear time-of-flight mass spectrometer. Theinstrument consisted of a 30 kilovolt two-stage acceleration sourcefollowed by a 1.4-meter field free drift region containing a particlewire guide. A frequency-tripled Nd:YAG (355 nm) LUMONICS HY 400 laserwas used for desorption/ionization. Ion signals were detected using ahybrid microchannel plate/discrete dynode electron multiplier andrecorded using a 500 MS/s transient recorder (TEKTRONIX TDS 520A)capable of fast signal averaging. The laser irradiance was adjustedduring signal averaging while monitoring the mass spectra on a samplingoscilloscope (TEXTRONIX TDS 310), in order to achieve optimum ion signal(significant signal versus maximum resolution). Time-of-flight spectrumwas generated by signal averaging 50 laser shots into a single spectrumand transferring the data to an IBM compatible personal computer. Datawas processed using the commercially available software, LABCALC(Galactic Industries). The time-of-flight mass spectrum was obtained inthe positive ion mode and externally calibrated with a calibrationequation generated using horse heart cytochrome c (molecular weight (MW)of 12,360 Da).

The resulting mass spectrum is reproduced in FIG. 2, clearly showing amass spectral signal for myotoxin a at MW=4,822 Da., -A- and a massspectral signal for the modified variant H-myotoxin a, at MW=5,242 Da.,-B-.

A 200 μL volume of a second specimen containing 0.002 mg/ML of wholevenom in human whole blood and 40 nM H-myotoxin like the first sampleabove, was mixed with the MALDI matrix, sinapinic acid(α-cyano-4-hydroxycinnamic acid saturated in 1:2, acetonitrile:1.33%aqueous trifluoroacetic acid), and placed on a mass spectrometric probetip. After drying, the sample was then placed in a time-of-flight massspectrometer and MALDI mass spectrometrically analyzed. The resultingmass spectrum is reproduced in FIG. 3 showing no signals for either ofthe myotoxin a species, rather, the mass spectrum is dominated bysignals due to hemoglobin, i.e., hemoglobin A and B chain signals areobserved at ˜16,000 Da (and doubly-charged at ˜8,000 Da). This exampledemonstrates the necessity of affinity capture and isolation prior toMALDI mass spectrometric analysis to detect myotoxin a.

The myotoxin a in the first specimen above containing 0.002 mg/mL ofwhole venom and 40 nM H-myotoxin a, was then quantified using a workingcurve strategy. Six preliminary samples which consisted of 50 μL SB, 150μL tris, and 2 μL×0.02 mg/mL of the H-myotoxin a internal reference (40nM in each sample) were prepared. To each preliminary sample an aliquotof either 5, 10, 20, 30, 40 or 50 μL of a purified myotoxin a solution(0.002 mg/mL) was added, resulting in a myotoxin a concentration rangeof 10 nM to 100 M. Each preliminary sample was then massspectrometrically immunoassayed as was the first specimen except thatthree 50-laser shot mass spectra were acquired for each sample ratherthan one. A specimen containing 2 μL aliquot of C.v.viridis venom at aconcentration of 0.2 mg/mL (resulting after dilution in a concentrationof 0.002 mg/mL) was treated in the same manner.

A six-point normal working curve was generated from the mass spectradata of the preliminary samples. The mass spectra of the specimen andall six preliminary samples were normalized to the signal intensity ofthe H-myotoxin a. The relative signal intensity of the myotoxin a in thepreliminary samples (the average of the three spectra) was then plottedas a function of myotoxin a concentration thereby generating a six pointworking curve. FIG. 4 shows the working curve which relates theconcentration of purified myotoxin a with the normalized signalintensity of the myotoxin a. Indicated at -5- is the normalizedintensity observed for the specimen. The concentration of myotoxin a inthe specimen was determined to be 25 nM.

EXAMPLE 2

Myotoxin a present in a blood sample containing 0.002 mg/mL of C.v.viridis venom was quantified employing the bargraph quantificationstrategy. Introduced into the sample were multiple internal referencespecies of myotoxin a which had been iodinated (at the tyrosineresidues) using the following procedure: Iodobeads (Pierce) were washedtwo times with 0.1 M sodium phosphate at pH 7.0, then incubated for fiveminutes with 0.4 M sodium iodide in a 0.1 M sodium phosphate solution atpH 7.0. An equal volume of myotoxin a, 2 mg/mL in buffer, was added tothe sodium iodide/lodobead solution. Two Iodobeads were used for eachmilligram of myotoxin a. The mixture was incubated overnight (˜10 hours)at room temperature, after which the reaction was stopped by removal ofthe Iodobeads. The modified protein was desalted and stored as describedabove. The reaction resulted in the production of four distinctiodinated species, with each addition incrementing the molecular weightof myotoxin a by 126 Da (the difference between the atomic weight ofiodine and the atomic weight of the displaced proton). Immunoassay andmass spectral procedures were the same as described in Example 1.

The internal reference species comprising the bargraph were calibratedagainst known concentrations of purified myotoxin a (using thecalibration procedure described in Example 1). Once the relationshipsbetween the signal intensities of the myotoxin a and the internalreference species was established, the concentration of myotoxin apresent in the sample could be determined, at a glance, by correlationwith the internal reference peaks of closest intensity. For the exampleshown in FIG. 5, concentrations of 20, 100, 130 and 30 nM are indicatedby the signal intensities of the first through fourth MV, -D-, -E-, -F-,and -G-, respectively. As the intensity of the myotoxin a signal -H- isobserved to be between that of the first and fourth MV, it is determinedthat the myotoxin a concentration is in the range of 20 to 30 nM.

EXAMPLE 3

FIG. 6 demonstrates a single-point relative signal strategy forquantifying and detecting myotoxin a in human blood. A human bloodsample containing an unknown concentration of myotoxin a and a 30 nMconcentration of H-myotoxin a was prepared then mass spectrometricallyimmunoassayed according to the protocols of Example 1 above. Theresulting mass spectrum shows mass spectral signals for myotoxin a, -I-,and H-myotoxin a, -J-, at their respective molecular weights. Therelative mass spectrometric responses of myotoxin a and H-myotoxin a maybe determined from the mass spectrum of FIG. 2 in which theconcentrations of both species are known (25 nM myotoxin a, from theworking curve calibration, and 40 nM H-myotoxin a). From thiscalibration it may be determined that equal concentrations of the twoanalytes give a 10% lower signal for H-myotoxin a. The myotoxin a signalis 3.5 times the H-myotoxin a signal for a known 30 nM concentration ofH-myotoxin a. Therefore the myotoxin a concentration is calculated to be(30 nM×3.5/1.1) or 95 nM.

EXAMPLE 4

A multiplex mass spectrometric immunoassay was performed tosimultaneously detect the presence of myotoxin a and Mojave toxin inhuman blood.

The protocols of Example 1 above were followed with two exceptions.First, anti-myotoxin a and anti-Mojave toxin basic subunitimmunoglobulins IgG were immobilized on 6% agarose beads resulting in anaffinity reagent containing antibodies towards both myotoxin a andMojave toxin. Second, the specimens of human blood contained 0.002 mg/mLof the whole venom of the Mojave rattlesnake, Crotalus scutulatusscutulatus (C.s. scutulatus), rather than the venom of C.v.viridis, andthe specimens did not contain the internal reference species, H-myotoxina. The venom of the C.s.scutulatus contains both myotoxin a and Mojavetoxin.

The mass spectrum resulting from the complete mass spectrometricimmunoassay of a specimen is reproduced in FIG. 7, clearly showing amass spectral signal for myotoxin a at MW=4,822 Da., -K-, and Mojavetoxin at MW=14,175 Da., -L-. Also observed in the mass spectrum aresignals due to the hemoglobin present in the blood sample (A- andB-chains at MW of ˜16,000 Da). These did not prove a seriouscomplication to the assay as the toxin signals are clearly observed atresolved values.

Mere MALDI mass spectrometric analysis of another identical specimenwithout affinity capture and isolation of myotoxin a and Mojave toxinyielded a mass spectrum with no discernable signals for the toxinssimilar to that shown in FIG. 3.

EXAMPLE 5

Example 5 demonstrates the detection and quantification of the bloodserum protein a-1-acid glycoprotein (hence A1AG) using a massspectrometric immunoassay in which the internal reference species isintrinsic to the biological system was performed. The internal referencespecies in this example is human serum albumin (hence HSA), anotherblood serum protein. A working-curve method was employed. The examplewas performed, to demonstrate principle, in a solution of normal saline.

Five preliminary samples were prepared containing a constantconcentration of HSA to serve as the internal reference species, andalso containing A1AG in the range of 2.5 nM to 27.5 nM. Each preliminarypreparation was mass spectrometrically immunoassayed with a separateaffinity reagent made of both an immobilized antibody to HSA and animmobilized antibody to A1AG. The resulting mass spectrum from one ofthe preliminary preparations (containing 27.5 nM A1AG) is shown in FIG.8 with the HSA signal at -N- and the A1AG signal at -M-. All resultingmass spectra in this example were normalized to the HSA signal, and thenormalized signal intensities of the A1AG were then used to constructthe working curve depicted in FIG. 9.

An analytical sample, known to contain 12.5 nM A1AG was massspectrometrically immunoassayed under similar conditions for thepreparations above. The resulting A1AG signal was within thatrepresented on the 5-point working curve of FIG. 9 and is shown at point-O- corresponding to an A1AG concentration of ˜12.5 nM which verifiesthe accuracy of the working curve quantification method.

EXAMPLE 6

The use of mass spectrometric immunoassay and the standard additionquantification strategy to detect and quantify myotoxin a in human bloodlaced with the venom of the Mojave rattlesnake, C.s.scutulus wasperformed. The venom of the Mojave rattlesnake contains both myotoxin aand Mojave toxin. The Mojave toxin intrinsic to the specimen is used inthis example as an internal reference species to quantify myotoxin a.

A venom-laced blood sample was first divided equally amongst fiveseparate containers. Aliquots of purified myotoxin a were added to eachcontainer, resulting in the samples possessing myotoxin a concentrationsof 0, 180, 540, 890 and 1250 nM over that intrinsic to the sample. Allfive samples were then mass spectrometrically immunoassayed according tothe protocols of Example 4 and the resulting mass spectra normalized tothe Mojave toxin signals. FIG. 10 reproduces the results from thestandard addition analysis in which myotoxin a was added at aconcentration of 1250 nM over the intrinsic level. The signals formyotoxin a and Mojave toxin are observed at -P- and -Q-, respectively.

The normalized myotoxin a signals were then plotted as a function of theconcentration of myotoxin a (added), and the points fit with a straightline as shown in FIG. 11. The standard addition line was thenextrapolated to the baseline (concentration of added myotoxin a). Theintercept point, -R-, indicated the concentration of myotoxin aintrinsic to the specimen to be 190 nM.

EXAMPLE 7

A multiplex mass spectrometric immunoassay was performed to detectmyotoxin a and Mojave toxin in human blood. The myotoxin a was thenquantified using the bargraph approach and the Mojave toxin wasquantified using a working curve in which the doubly-iodinated speciesserves as an internal reference species. A venom laced blood sample andaffinity reagent were prepared according to the protocols outlined inExample 1 with two exceptions:1) the venom used to lace a human bloodsample was that of C.s. scutulatus, and 2) two antibodies, anti-myotoxina and anti-Mojave basic subunit, were present in the antibody solutionused to prepare the affinity reagent.

The mass spectrometric immunoassay proceeded as outlined in Example 1with the iodinated modified variants of myotoxin a described in Example2 introduced into the sample as internal reference species. Calibrationof the bargraph was as in Example 2 and the working curve as in Example6 with the doubly-iodinated species of myotoxin a serving as theinternal reference. The mass spectrum resulting from the analyticalsample containing 0.001 mg/mL C.s. scutulatus is shown in FIG. 12. Massspectral signals are observed at 4,822 Da, -S-, indicating the presenceof myotoxin a, and 14,175 Da, -T-, indicating the presence of Mojavetoxin basic subunit. The iodinated myotoxin a signals are also observedat ˜4,950-5,320 Da, -U-.

The myotoxin a signal registered between that of the 1st and 4thiodinated species indicating a concentration between 2 and 3 nM. Fromthe working curve it was determined that the Mojave toxin basic subunitconcentration was 15 nM±2.5 nM.

EXAMPLE 8

The mass spectrometric immunoassay method of determining the presence ofone or more specific antibodies in sera was performed. The methodinvolves retrieval of a portion of the general antibody populationpresent in a sample, and use of this portion to construct the affinityreagent. The affinity reagent is then screened with specific antigens.Antigens are retained by the affinity reagent if the specific antibodyis present in the original sample, and will register in the massspectrum (indicating the presence of the specific antibody).

The specimen was that of blood serum drawn from a rabbit immunizedagainst the toxin, α-cobratoxin. The affinity reagent was prepared bymixing 25 μL of protein A supported on 6% agarose beads with a solutioncontaining 50 μL of the serum and 50 μL of 0.01M tris[Hydroxymethyl]aminomethane, pH 8.2 (tris)) and incubated for two hours (gentleagitation at room temperature). Following incubation, the beads werewashed (3×100 μL tris) and allowed to react at room temperature with 50μL of 0.02 M dimethylpimelimidate dihydrochloride prepared in 0.2 Mtriethanolamine (pH 8.2). The reaction was stopped after one hour bywashing (3×100 μL) with 0.2 M triethanolamine followed by 100 μL of 0.2M sodium citrate buffer (pH 2.8). The affinity reagent was finallywashed (3×100 μL) with tris and resuspended in 50 μL of the same buffer.

A preparation containing multiple antigen species was prepared and MALDImass spectrometrically analyzed. The resulting mass spectrum in FIG. 13shows multiple signals corresponding to multiple antigens in thepreparation. The singly charged signal for (α-cobratoxin is identifiedat -V- at the molecular weight of 7,822 Da.

The affinity reagent was then incubated with the preparation followingsimilar mass spectrometric immunoassay protocols already described tosee which of the antigen species from the preparation of screeningantigens were retained. The resulting mass spectrum is shown in FIG. 14.A signal at the mass-to-charge ratio of α-cobratoxin at 7,822 m/z(molecular weight 7,822 Da), -W-, indicates the retention ofα-eobratoxin by the affinity reagent, which in turn indicates thepresence of anti-α-cobratoxin present in the serum from which theaffinity reagent was made.

From the foregoing, it is readily apparent that new useful embodimentsof the present invention have been herein described and illustratedwhich fulfills all of the aforestated objectives in a remarkablyunexpected fashion. It is of course understood that such modifications,alterations and adaptations as may readily occur to the artisanconfronted with this disclosure are intended within the spirit of thisdisclosure which is limited only by the scope of the claims appendedhereto.

Accordingly, what is claimed is:
 1. A method of analyzing a sample todetermine if it includes one or more analytes consisting of: placing thesample in contact with an affinity reagent to create a post-combinationaffinity reagent; separating the post-combination affinity reagent fromany unbound remainder of the sample to create an isolatedpost-combination affinity reagent; washing the isolated post-combinationaffinity reagent; releasing one or more analytes bound to the affinityreagent to produce a solution having one or more unbound analytes byadding a disassociation agent to the washed and isolatedpost-combination affinity reagent; performing mass spectrometry on thesolution; and analyzing results of the mass spectrometry to detect anyof the one or more analytes present in the sample and identify the oneor more analytes.
 2. The method according to claim 1 where the sample isbiological.
 3. The method according to claim 1 where the sample isheterogeneous.
 4. The method of claim 1 where the presence or absence ofone or more analytes correlates to a biological process or a disease. 5.The method according to claim 1 where the affinity reagent comprises anantibody immobilized onto a substrate selected from the group consistingof agarose beads, nylon, a metal, glass, silicon, and organic membrane.6. The method according to claim 5 where the substrate is containedwithin a micropipette tip.
 7. The method according to claim 1 where thedisassociation agent includes at least one of adding a buffer solution,heating, sonicating, applying an electric potential, and adding a laserdesorption/ionization agent.
 8. The method according to claim 1 furthercomprising the step of adding a laser desorption/ionization agent priorto the step of performing mass spectrometry.
 9. The method according toclaim 1 further comprising the act of quantifying the amount of the oneor more analytes present in the sample by: combining the sample with aknown amount of internal reference species (IRS) if the specimen doesnot already contain one prior to placing the sample in contact with anaffinity reagent; separating the post-combination affinity reagent whichincludes the IRS from any unbound remainder of the sample; washing thepost-combination affinity reagent which includes the IRS; releasing oneor more analytes and IRS bound to the affinity reagent to produce asolution having one or more unbound analytes and unbound IRS by adding adisassociation agent to the washed and isolated post-combinationaffinity reagent which includes the IRS; and quantifying the one or moreanalytes using mass spectrometric analysis to resolve distinct signalsfor the one or more unbound analytes and unbound IRS to determine theamount of the captured one or more analytes relative to the IRS.
 10. Amethod for quantifying an amount of one or more analytes present in aspecimen consisting of the steps of: combining the specimen with a knownamount of internal reference species (IRS) if the specimen does notalready contain one; capturing and isolating at least one of the one ormore analytes and the IRS using an affinity reagent having a specificaffinity for the one or more analytes and the IRS; releasing theisolated one or more analytes and the IRS by eluting the one or moreanalytes and the IRS from the affinity reagent; and quantifying the oneor more analytes by using mass spectrometric analysis to resolvedistinct signals for the one or more analytes and the IRS to determinethe amount of the captured one or more analytes relative to the IRS. 11.The method of claim 9 where the step of capturing and isolating at leastone of the one or more analytes and the IRS using an affinity reagentincludes the step of immobilizing an antibody onto a substrate selectedfrom the group consisting of agarose beads, nylon, a metal, glass,silicon, and organic membrane.
 12. The method according to claim 11where the substrate is contained within a micropipette tip.
 13. Themethod of claim 10 where the step of releasing the isolated one or moreanalytes and IRS bound to the affinity reagent includes the step ofadding a disassociation agent to the isolated one or more analytes andIRS bound to the affinity reagent.
 14. The method according to claim 13where the disassociation agent includes at least one of adding a buffersolution, heating, sonicating, applying an electric potential, andadding a laser desorption/ionization agent.
 15. The method according toclaim 10 further comprising the step of adding a laserdesorption/ionization agent prior to the step of quantifying using massspectrometric analysis.